|
17-hydroxypregnenolone
|
$71.85 |
$71.85 |
$71.85 |
$85.15
|
|
2nd order venous cath
|
$2,554.93 |
$2,554.93 |
$2,554.93 |
$1,809.60
|
|
#a/b/c/c/h pnl-candida albicans ab
|
$81.20 |
$81.20 |
$81.20 |
$52.25
|
|
Abd/low ext cath 1st
|
$7,788.53 |
$7,788.53 |
$7,788.53 |
$2,608.45
|
|
Abd/low ext cath 2nd
|
$6,578.02 |
$6,578.02 |
$6,578.02 |
$2,517.20
|
|
Abd/low ext cath 3rd
|
$8,792.92 |
$8,792.92 |
$8,792.92 |
$3,050.58
|
|
Abd/low ext cath addl
|
$2,433.83 |
$2,433.83 |
$2,433.83 |
$1,009.00
|
|
Abdominal CT scan (with and without contrast)
|
$12,580.49 |
$12,580.49 |
$12,580.49 |
$2,049.00
|
|
Abdominal CT scan (with contrast)
|
$10,159.63 |
$10,159.63 |
$10,159.63 |
$1,683.63
|
|
Abdominal CT scan (without contrast)
|
$8,427.48 |
$8,427.48 |
$8,427.48 |
$1,358.76
|
|
Abdominal MRI (with and without contrast)
|
$22,740.00 |
$22,740.00 |
$22,740.00 |
$2,916.21
|
|
Abdominal MRI (with contrast)
|
$8,161.52 |
$8,161.52 |
$8,161.52 |
$2,187.60
|
|
Abdominal MRI (without contrast)
|
$16,214.30 |
$16,214.30 |
$16,214.30 |
$1,972.66
|
|
Abdominal paracentesis w/image guidance
|
$2,399.01 |
$2,399.01 |
$2,399.01 |
$1,666.30
|
|
Abdominal Ultrasound (complete)
|
$3,511.87 |
$3,511.87 |
$3,511.87 |
$759.57
|
|
Abdominal Ultrasound (limited)
|
$2,536.78 |
$2,536.78 |
$2,536.78 |
$603.33
|
|
Abd paracentesis/w/o image guide 49082
|
$2,399.01 |
$2,399.01 |
$2,399.01 |
$1,170.28
|
|
Acetaminophen 10 mg/ml soln 100 ml glass cont
|
$276.25 |
$276.25 |
$276.25 |
$125.63
|
|
Acetaminophen level
|
$237.26 |
$237.26 |
$237.26 |
$117.01
|
|
Acetazolamide 500 mg solution for injection
|
$1,002.00 |
$1,002.00 |
$1,002.00 |
$133.60
|
|
Acetone qualitative
|
$122.28 |
$122.28 |
$122.28 |
$47.45
|
|
Acetylcysteine 200 mg/ml (20 %) intravenous solution
|
$423.96 |
$423.96 |
$423.96 |
$323.77
|
|
Acute hepatitis panel
|
$278.33 |
$278.33 |
$278.33 |
$284.70
|
|
Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr
|
$185.18 |
$185.18 |
$185.18 |
$50.70
|
|
Adenosine 3 mg/250 ml bag for osm
|
$3,191.89 |
$3,191.89 |
$3,191.89 |
$219.86
|
|
Adh-sendout
|
$106.91 |
$106.91 |
$106.91 |
$109.28
|
|
Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution
|
$148.92 |
$148.92 |
$148.92 |
$124.70
|
|
Administration immunization 1 vaccine
|
$198.67 |
$198.67 |
$198.67 |
$70.52
|
|
Administration immunization each additional vaccine
|
$181.42 |
$181.42 |
$181.42 |
$46.23
|
|
Administration vaccine influenza virus
|
$2,358.24 |
$2,358.24 |
$2,358.24 |
$49.50
|
|
_afb org id by sequencing rflx ast-sendout
|
$381.55 |
$381.55 |
$381.55 |
$289.60
|
|
Albumin body fluid quantitative each specimen
|
$33.09 |
$33.09 |
$33.09 |
$48.00
|
|
Albumin (human), 25%, 50ml
|
$3,545.83 |
$3,545.83 |
$3,545.83 |
$295.80
|
|
Albumin, human 25 % intravenous solution
|
$2,126.36 |
$2,126.36 |
$2,126.36 |
$488.08
|
|
Albumin (human), 5%, 250 ml
|
$3,425.05 |
$3,425.05 |
$3,425.05 |
$295.80
|
|
Albumin (microalbumin) 24 hour urine quantitative
|
$244.63 |
$244.63 |
$244.63 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$457.33 |
$457.33 |
$457.33 |
$43.50
|
|
Albuterol ipratrop non-comp
|
$63.79 |
$63.79 |
$63.79 |
$22.45
|
|
Albuterol non-comp unit
|
$15.62 |
$15.62 |
$15.62 |
$9.59
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$339.82 |
$339.82 |
$339.82 |
$93.60
|
|
Alkaline phosphatase
|
$42.49 |
$42.49 |
$42.49 |
$46.20
|
|
Allergen alpha lactalbumin ige
|
$83.03 |
$83.03 |
$83.03 |
$56.35
|
|
Allergen egg white ige
|
$18.12 |
$18.12 |
$18.12 |
$41.00
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,465.59 |
$1,465.59 |
$1,465.59 |
$905.18
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$1,707.62 |
$1,707.62 |
$1,707.62 |
$3,025.07
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$729.21 |
$729.21 |
$729.21 |
$189.00
|
|
Alpha-fetoprotein tumor marker
|
$181.10 |
$181.10 |
$181.10 |
$99.00
|
|
Alteplase 100 mg infusion from pyxis vial
|
$3,207.97 |
$3,207.97 |
$3,207.97 |
$2,600.22
|
|
Alt/sgpt
|
$457.33 |
$457.33 |
$457.33 |
$49.00
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$127.90 |
$127.90 |
$127.90 |
$41.59
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$1,017.00 |
$1,017.00 |
$1,017.00 |
$202.10
|
|
Amiodarone 50 mg/ml intravenous solution
|
$318.29 |
$318.29 |
$318.29 |
$47.44
|
|
Amitriptyline (elavil) -sendout
|
$343.29 |
$343.29 |
$343.29 |
$101.17
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$106,669.60 |
$106,669.60 |
$106,669.60 |
$15,167.75
|
|
Ammonia
|
$599.61 |
$599.61 |
$599.61 |
$120.90
|
|
Ampicillin 1 gram solution for injection
|
$183.91 |
$183.91 |
$183.91 |
$57.76
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$339.08 |
$339.08 |
$339.08 |
$51.93
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$788.97 |
$788.97 |
$788.97 |
$312.00
|
|
Amylase
|
$627.27 |
$627.27 |
$627.27 |
$93.00
|
|
Analysis gene f2 20210g>a variant
|
$228.13 |
$228.13 |
$228.13 |
$219.60
|
|
Analysis gene f5 leiden variant
|
$254.81 |
$254.81 |
$254.81 |
$226.60
|
|
Anca screen with reflex to titer -quest
|
$336.23 |
$336.23 |
$336.23 |
$109.20
|
|
An fluoro guide for cvp
|
$2,930.37 |
$2,930.37 |
$2,930.37 |
$484.45
|
|
Angio balloon ctrl dialysis seg add-on
|
$21,995.02 |
$21,995.02 |
$21,995.02 |
$5,799.20
|
|
Angioplasty fem/pop unilat 37224
|
$51,400.92 |
$51,400.92 |
$51,400.92 |
$9,182.45
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$24,211.66 |
$24,211.66 |
$24,211.66 |
$11,524.11
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$13,610.89 |
$13,610.89 |
$13,610.89 |
$6,513.10
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$5,501.23 |
$5,501.23 |
$5,501.23 |
$6,736.02
|
|
Angio tib/peroneal/init ves/unila 37228
|
$19,794.56 |
$19,794.56 |
$19,794.56 |
$13,351.25
|
|
Angio trnslmnl balloon same vein ini
|
$25,533.32 |
$25,533.32 |
$25,533.32 |
$8,689.20
|
|
Ankle X-ray
|
$1,233.74 |
$1,233.74 |
$1,233.74 |
$339.44
|
|
Antibody elution rbc reference
|
$455.16 |
$455.16 |
$455.16 |
$176.54
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$427.16 |
$427.16 |
$427.16 |
$220.73
|
|
Antibody id rbc panel
|
$915.98 |
$915.98 |
$915.98 |
$291.75
|
|
Antibody screen rbc
|
$395.52 |
$395.52 |
$395.52 |
$105.00
|
|
Anti mog serum - sendout
|
$69.75 |
$69.75 |
$69.75 |
$140.62
|
|
Antineutrophil cytoplasmic antibody screen each antibody
|
$55.80 |
$55.80 |
$55.80 |
$50.88
|
|
Antineutrophil cytoplasmic antibody titer each antibody
|
$55.80 |
$55.80 |
$55.80 |
$45.82
|
|
Antinuclear antibodies
|
$124.49 |
$124.49 |
$124.49 |
$91.70
|
|
Antinuclear antibodies titer
|
$180.86 |
$180.86 |
$180.86 |
$80.25
|
|
Antiphosphatidylserine antibody
|
$454.02 |
$454.02 |
$454.02 |
$74.20
|
|
Antistreptolysin o screen
|
$18.18 |
$18.18 |
$18.18 |
$59.40
|
|
Antistreptolysin o titer
|
$25.36 |
$25.36 |
$25.36 |
$57.96
|
|
Antithrombin iii activity
|
$37.33 |
$37.33 |
$37.33 |
$115.23
|
|
Apheresis rbc
|
$2,441.66 |
$2,441.66 |
$2,441.66 |
$3,348.50
|
|
App high cost ss f/n/g/h/f <100sq cm addl <25sq cm
|
$159.25 |
$159.25 |
$159.25 |
$549.08
|
|
App high cost ss t/a/l <100sq cm addl <25sq cm
|
$2,212.37 |
$2,212.37 |
$2,212.37 |
$508.18
|
|
Application finger splntstatic 29130
|
$399.93 |
$399.93 |
$399.93 |
$216.80
|
|
Application long leg splint 29505
|
$1,783.96 |
$1,783.96 |
$1,783.96 |
$340.80
|
|
Application lower leg splint 29515
|
$455.38 |
$455.38 |
$455.38 |
$355.85
|
|
Application multi layer compression below knee (both sides)
|
$649.69 |
$649.69 |
$649.69 |
$397.00
|
|
Application of forearm cast 29075
|
$776.96 |
$776.96 |
$776.96 |
$379.20
|
|
Application of long arm cast 29065
|
$776.96 |
$776.96 |
$776.96 |
$404.63
|
|
Application of paste boot 29580
|
$649.69 |
$649.69 |
$649.69 |
$331.74
|
|
Application short leg cast 29405
|
$855.66 |
$855.66 |
$855.66 |
$393.98
|
|
Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm
|
$4,036.18 |
$4,036.18 |
$4,036.18 |
$2,148.25
|
|
Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm
|
$4,036.18 |
$4,036.18 |
$4,036.18 |
$2,120.95
|
|
Appl modality 1/> areas paraffin bath 97018
|
$198.66 |
$198.66 |
$198.66 |
$69.55
|
|
Appl modality 1/> areas vasopneumatic devices 97016
|
$167.22 |
$167.22 |
$167.22 |
$75.98
|
|
Apply finger cast 29086
|
$501.10 |
$501.10 |
$501.10 |
$225.29
|